Organization
SOUTHPORT TRANSPORTATION INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL F NARDI (PRESIDENT)
(262) 658-3674
Entity
Organization
Contact information
Practice address
5911 57TH AVE, KENOSHA, WI 53144-2240
(262) 658-3674
(262) 658-4779
Mailing address
5911 57TH AVE, KENOSHA, WI 53144-2240
(262) 658-3674
(262) 658-4779
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100022665
—
WI
Enumeration date
09/12/2012
Last updated
09/12/2012
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